Individual
DR. RONALD MATHIASEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10670 WEXFORD ST, SAN DIEGO, CA 92131-3940
(858) 621-4090
(858) 621-4044
Mailing address
10670 WEXFORD ST, SAN DIEGO, CA 92131-3940
(858) 621-4090
(858) 621-4044
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
A064829
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A648290
—
CA
01
—
020045191
RAILROAD
CA
Enumeration date
04/20/2006
Last updated
06/25/2013
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